By submitting this registration, I agree to the terms of becoming a Back on My Feet FundRacer to include: I authorize Back on My Feet to charge my credit card $25 to reserve my place as a BoMF FundRacer and my entry to Broad Street Run 2018 . This $25 will be applied to my fundraising total. I agree to raise the minimum fundraising amount of $500 for a position as a FundRacer for the Broad Street Run 2018 Event. I understand the fundraising minimum must be reflected on my personal online fundraising account by May 06, 2018 . I agree to provide Back on My Feet with a credit card valid through December 2016. If I have not raised half of the fundraising minimum by ONE MONTH AFTER (June 6, 2017), I authorize Back on My Feet to charge my credit card the amount required to reach half the fundraising minimum or the bib may be pulled at the discretion of Back on My Feet. I also understand that my position as a Back on My Feet FundRacer is non-transferable. If at any time or for any reason I am unable to participate in the event, I will contact the event managers. Regardless of whether I can participate in the event, I am still responsible to raise the minimum amount. Registration and Donations are not refundable for any reason. I understand that failure to meet the fundraising minimum puts my future participation with Back on My Feet events in jeopardy.

Back on My Feet Participant Release

In consideration for the opportunity to participate in the Broad Street Run 2018 (the “Event”) as a Back on My Feet FundRacer, I agree as follows:

1.I hereby waive and release, for myself, my heirs, executors and administrators, any and all rights, claims, liabilities and causes of action whatsoever I may have against Back on My Feet, its affiliates and the Event operators and sponsors and each of their respective officers, directors, employees and agents (the “Event Parties”) relating to or arising from my participation in the Event, including but not limited to personal injury.

2.I recognize the Event has inherent risk of injury and I hereby assume that risk. If I cause injury to any person or damage to any property while participating in the Event, I hereby indemnify and hold harmless the Event Parties from and against any and all claims, suits, actions, loses, damages and expenses related to or arising from such injury or damage.

3. I hereby give my consent to Back on My Feet and its affiliates to use my name and photographs, video and film (“Photos”) of me taken before, during or after the Event in advertising and promotional materials for Back on My Feet, including but not limited to the Internet, without compensation. I agree that no advertising or other material need be submitted to me for approval. I agree that all Photos of me used by Back on My Feet and its affiliates are owned by Back on My Feet and they may copyright material containing same. I hereby release, discharge, and agree to save harmless the Event Parties from any liability, including, without limitation, any claims for libel or invasion of publicity/privacy, by virtue of any use of my name and/or Photos, including, any alteration of such Photos, whether intentional or otherwise.

I have read and understand this Release, and declare all information is truthful and accurate.Please read and acknowledge the waiver via your initials above and by checking the box.